﻿<div class="tab_left_1"></div>
<div class="tab_bg_cennter">Thông tin và địa chỉ giao hàng</div>
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<div class="box_bd_bg">
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<form method="post" action="index.php?option=com_ecommerce&task=order">
	<input type="hidden" name="option" value="com_ecommerce" />
   	<input type="hidden" name="task" value="order" />
	<table width="100%" border="0" cellpadding="5" cellspacing="2" >
  <tr class="tab_left_ececec">
    <td align="right">Tên người liên hệ:</td>
    <td ><input type="text" name="order_contact_name"  id="order_contact_name" class="text_box_order" value="<? echo $order_contact_name;?>" /></td>
  </tr>
  <tr>
    <td align="right" >Địa chỉ giao hàng:</td>
    <td><input type="text" name="order_address" id="order_address" class="text_box_order" value="<? echo $order_address;?>" /></td>
  </tr>
  <tr class="tab_left_ececec">
    <td align="right">Số điện thoại:</td>
    <td><input type="text" name="order_phone" id="order_phone" class="text_box_order" value="<? echo $order_phone;?>" /></td>
  </tr>
  <tr>
    <td align="right">Số fax:</td>
    <td><input type="text" name="order_fax" id="order_fax" class="text_box_order" value="<? echo $order_fax;?> " /></td>
  </tr>
  <tr class="tab_left_ececec">
    <td align="right">Email:</td>
    <td><input type="text" name="order_email" id="order_email" class="text_box_order" value="<? echo $order_email;?>" /></td>
  </tr>
  <tr>
    <td align="right">Thông tin xuất hóa đơn GTGT:</td>
    <td><textarea name="order_info" id="order_info" class="textarea_box_order"><? echo $order_info;?></textarea></td>
  </tr>
   <tr class="tab_left_ececec">
    <td align="right">Hình thức thanh toán:</td>
    <td>
    	<!--<label><input type="radio" name="order_method" id="order_method1" value="1" /> Thanh toán trực tuyến</label><br />-->
        <label><input type="radio" name="order_method" id="order_method2" value="2" /> Thanh toán chuyển khoản</label><br />
        <label><input type="radio" name="order_method" id="order_method3" value="3" /> Thanh toán tiền mặt khi nhận hàng</label>
     </td>
  </tr>
  <tr>
    <td colspan="2" align="center"><input type="reset" name="reset" id="reset" value="Nhập lại" />  <input type="submit" name="submit" id="submit" value="Chấp nhận" /></td>
  </tr>
</table>
</form>
<script language="javascript" type="text/javascript" >
 if('<? echo $order_method;?>'!='') $('order_method<? echo $order_method;?>').checked=true;

</script>
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</div>
<div class="box_bd_bottom"><div class="right"></div></div>
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